Placing pills in a bottle and delivering it to the nursing staff at the hospital or directly to the patient at the check-out or drive-thru window is only a small part of the duties of a pharmacist. They have a key role and responsibility in ensuring that the right drug in the right amount with the right instructions reaches the patient.
The State of Ohio recognizes the significance of the position pharmacists have in the provision of healthcare. The Ohio Revised Code (4729.01) sets out a detailed description of their duties, including:
B) "Practice of pharmacy" means providing pharmacist care requiring specialized knowledge, judgment, and skill derived from the principles of biological, chemical, behavioral, social, pharmaceutical, and clinical sciences. As used in this division, "pharmacist care" includes the following:
(1) Interpreting prescriptions;
(2) Dispensing drugs and drug therapy related devices;
(3) Compounding drugs;
(4) Counseling individuals with regard to their drug therapy, recommending drug therapy related devices, and assisting in the selection of drugs and appliances for treatment of common diseases and injuries and providing instruction in the proper use of the drugs and appliances;
(5) Performing drug regimen reviews with individuals by discussing all of the drugs that the individual is taking and explaining the interactions of the drugs;
(6) Performing drug utilization reviews with licensed health professionals authorized to prescribe drugs when the pharmacist determines that an individual with a prescription has a drug regimen that warrants additional discussion with the prescriber;
(7) Advising an individual and the health care professionals treating an individual with regard to the individual's drug therapy;
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These are important responsibilities, and falling short of any of them can lead to serious and harmful consequences for the patient. Pharmacists can provide the wrong medicine, give the wrong dose of the right medicine, specify the wrong route of administration, or fail to appreciate that a drug being prescribed is not to be given due to another medication a patient is taking because of dangerous interactions. Pharmacists should but sometimes do not utilize their specialized knowledge and judgment and inappropriately defer to a physician, allowing the prescriber to override legitimate concerns the pharmacists may have. They may fail to adequately caution patients regarding particular risks they have a responsibility to discuss with a patient.
Problems may arise for a variety of reasons, from inadequate knowledge or training to assuming the computer system is flawless and will flag any errors. The communication between physician and pharmacist is critical and may be a key source of breakdown. The potential for miscommunication also can be increased by the fact that both parties often delegate the communication to staff. In addition, pharmacists have a supervisory role over pharmacy technicians and can become complacent in fulfilling that duty.
Pharmacy errors can be just as devastating as substandard care by physicians and other members of the healthcare team. They are not just go-betweens for a doctor and a patient; pharmacists have independent duties and are no less responsible when they fail to meet the standard of care required of them.